Osteoporosis International

, Volume 22, Issue 9, pp 2539–2549

Zoledronic acid results in better health-related quality of life following hip fracture: the HORIZON–Recurrent Fracture Trial

  • J. D. Adachi
  • K. W. Lyles
  • C. S. Colón-Emeric
  • S. Boonen
  • C. F. Pieper
  • C. Mautalen
  • L. Hyldstrup
  • C. Recknor
  • L. Nordsletten
  • K. A. Moore
  • C. Bucci-Rechtweg
  • G. Su
  • E. F. Eriksen
  • J. S. Magaziner
Original Article

DOI: 10.1007/s00198-010-1514-9

Cite this article as:
Adachi, J.D., Lyles, K.W., Colón-Emeric, C.S. et al. Osteoporos Int (2011) 22: 2539. doi:10.1007/s00198-010-1514-9

Abstract

Summary

This study evaluated the benefits of ZOL versus placebo on health-related quality of life (HRQoL) among patients from HORIZON–RFT. At month 24 and end of the study visit, ZOL significantly improved patients’ overall health state compared to placebo as assessed by the EQ-5D VAS.

Introduction

To evaluate the benefits of zoledronic acid (ZOL) versus placebo on health-related quality of life (HRQoL) among patients from The Health Outcomes and Reduced Incidence With Zoledronic Acid Once Yearly Recurrent Fracture Trial (HORIZON–RFT).

Methods

In this randomized, double-blind, placebo-controlled trial, 2,127 patients were randomized to receive annual infusion of ZOL 5 mg (n = 1,065) or placebo (n = 1,062) within 90 days after surgical repair of low-trauma hip fracture. HRQoL was measured using EQ-5D Visual Analogue Scale (VAS) and utility scores (EuroQol instrument) at months 6, 12, 24, 36, and end of the study visit. Analysis of covariance model included baseline EQ-5D value, region, and treatment as explanatory variables.

Results

At baseline, patients (mean age 75 years; 24% men and 76% women) were well matched between treatment groups with mean EQ-5D VAS of 65.82 in ZOL and 65.70 in placebo group. At the end of the study, mean change from baseline in EQ-5D VAS was greater for ZOL vs. placebo in all patients (7.67 ± 0.56 vs. 5.42 ± 0.56), and in subgroups of patients experiencing clinical vertebral fractures (8.86 ± 4.91 vs. −1.69 ± 3.42), non-vertebral fractures (5.03 ± 2.48 vs. −1.07 ± 2.16), and clinical fractures (5.19 ± 2.25 vs. −0.72 ± 1.82) with treatment difference significantly in favor of ZOL. EQ-5D utility scores were comparable for ZOL and placebo groups, but more patients on placebo consistently had extreme difficulty in mobility (1.74% for ZOL vs. 2.13% for placebo; p = 0.6238), self-care (4.92% vs. 6.69%; p = 0.1013), and usual activities (10.28% vs. 12.91%; p = 0.0775).

Conclusion

ZOL significantly improves HRQoL in patients with low-trauma hip fracture.

Keywords

EQ-5D Health-related QoL Low-trauma hip fracture Zoledronic acid 

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2011

Authors and Affiliations

  • J. D. Adachi
    • 1
  • K. W. Lyles
    • 2
  • C. S. Colón-Emeric
    • 2
  • S. Boonen
    • 3
  • C. F. Pieper
    • 2
  • C. Mautalen
    • 4
  • L. Hyldstrup
    • 5
  • C. Recknor
    • 6
  • L. Nordsletten
    • 7
  • K. A. Moore
    • 2
  • C. Bucci-Rechtweg
    • 8
  • G. Su
    • 8
  • E. F. Eriksen
    • 9
  • J. S. Magaziner
    • 10
  1. 1.St. Joseph’s HealthcareMcMaster UniversityHamiltonCanada
  2. 2.Duke University Medical Center and the Geriatrics Research Education and Clinical Center, Veterans Affairs Medical CenterDurhamUSA
  3. 3.University of LeuvenLeuvenBelgium
  4. 4.Centro de Osteopatías MédicasBuenos AiresArgentina
  5. 5.Hvidovre HospitalHvidovreDenmark
  6. 6.United Osteoporosis CentersGainesvilleUSA
  7. 7.Ullevål University HospitalOsloNorway
  8. 8.Novartis Pharmaceuticals CorporationEast HanoverUSA
  9. 9.Oslo University Hospital AkerOsloNorway
  10. 10.University of MarylandBaltimoreUSA

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